Commonwealth Care, Speaking up!, Individual Mandate

At both HAN meetings, Brian Rosman from Health Care For All (HCFA) led a discussion about the next steps in Health Care Reform. Before he spoke, outreach workers exchanged stories about how some of new policies in Health Care Reform are working out in practice.

"Outreach & enrollment" means much more than putting up posters and helping people fill out MassHealth applications. Recently, over the course of a two hour appointment, my supervisor and I counseled one household on eleven different public health insurance, subsidy and care programs. We helped them file four separate applications to five different insurance programs, putting together a patchwork of care options to cover the hole left by the loss of employer-sponsored insurance.

This month, outreach workers gave some powerful examples of how the Commonwealth Care Open Enrollment process has added some new twists to the problem of access to providers.

Our last Boston HAN meeting came in the wake of the Connector Board’s decisions to shift more of the costs of Health Care Reform to consumers by raising co-pays and premiums for Commonwealth Care. Advocates continue to oppose these cost increases and push for sharing the costs more evenly with businesses. Meanwhile, outreach and enrollment workers are seeing an increase in administrative barriers to enrollment in Commonwealth Care and MassHealth.

Recently, I have seen an increase in the number of Exceptions Forms sent to Commonwealth Care applicants who the state believes have access to employer-sponsored insurance. These clients are not eligible for Commonwealth Care until they return the Form – but it can be hard to understand what makes the state mail it to these individuals in the first place.

Outreach workers do the hard work of explaining policy changes to real people, so often they are among the first to hear feedback about how they are working. Not surprisingly, this was a theme of the Western Mass. Health Access Network meeting this February, when we gathered with outreach and enrollment workers from Berkshire, Franklin, Hampshire and Hampden counties. HAN members doing enrollment agreed that there is still confusion and frustration in their communities.

December was intense... this is the 'take-away' from our Health Access Network meetings in Amherst and Boston this month. Across the board, people providing enrollment assistance in hospitals, community health centers and community organizations were faced with a huge number of people trying to get health insurance coverage before the Dec. 31 deadline. John Bergeron from Hilltowns Community Health Center got the prize for the latest request for assistance; he received several phone messages on the evening of December 31 from people looking to comply with the mandate.

It's been reported that over the past year more than about 200,000 Massachusetts residents have been provided access to comprehensive public health insurance: either through Commonwealth Care or MassHealth. What about those who aren't eligible for publicly subsidized programs and must enroll in employer-sponsored plans?

The increased cost of insuring employees and their families has forced many local employers to make hard choices about their insurance offerings.